Transdermal nitro-glycerine Versus oral Nifedipine for Acute Tocolysis in Preterm Labour: A randomised controlled trial
Objective: To compare the safety & efficacy of transdermal nitroglycerin with oral nifedipine in the inhibition of preterm labor.
Methodology: This study included 100 women in preterm labor, randomly divided into two groups, 50 receiving oral nifedipine and 50, transdermal nitroglycerin (NTG). Patients in preterm labour with a single gestation, between the 28th and the 34th week and no contraindication for tocolysis were selected. Women with fetal malformation and medical or obstetric diseases were excluded. The variables analyzed were: delay in delivery for 48 hours, 7 days or more than 7 days, period of gestation at delivery, side effect of drugs & neonatal outcomes.
Results: Mean prolongation of pregnancy with NTG (34.59days) was similar to that of nifedipine (29.09 days). Nitroglycerine was significantly more successful in prolonging pregnancy beyond 48 hours. Failure of acute tocolysis, defined as delivery within 48 hours, was significantly more common with nifedipine (32 %) as compared to transdermal nitroglycerin (12 %). Headache was significantly higher in the nifedipine group (42 %) compared to NGT group (4 %). The neonatal outcomes in terms of the mean birth weight, incidence of low birth weight and very low birth weight babies, need and duration of neonatal intensive care was similar in both groups.
Conclusion: Transdermal nitroglycerine is a safe and effective tocolytic with a lower failure rate and better side effect profile as compared with oral nifedipine.
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